Incidence and Significance of Patent Foramen Ovale After Correction of Tetralogy of Fallot

Abstract

Hemodynamic assessments were performed in 50 patients following correction of tetralogy of Fallot. In 10 patients, indicator dye-dilution curves demonstrated right-to-left shunting at the atrial level. The catheter crossed a patent foramen ovale in 3 additional patients. Right atrial mean pressure and right ventricular end-diastolic pressure were higher and systemic arterial oxygen saturation was lower in the patients with right-to-left shunting than in those without a shunt. Pulmonic regurgitation was present in 7 of the 10 patients with right-to-left shunting but not in the 3 without shunts. Two patients with right-to-left shunting sustained systemic arterial emboli, presumably paradoxical, during the late postoperative period. A patent foramen ovale should be closed at the time of surgical correction of tetralogy of Fallot.